Efficacy of mupirocin in methicillin-resistant Staphylococcus aureus burn wound infection.

Abstract

Methicillin-resistant Staphylococcus aureus strains (MRSA) have become increasingly prevalent as nosocomial pathogens, especially in burn wounds. MRSA constituted 38% of all S. aureus isolates in our 25-bed burns unit despite the utilization of a combination of 1% silver sulfadiazine and 0.2% chlorhexidine as topical therapy. Mupirocin, a new antibiotic, has proved in vitro and in vivo to be highly effective in the treatment of MRSA infections. A prospective clinical trial with mupirocin ointment in MRSA burn wound infection was untertaken. Forty-five children with 59 discrete burn wounds and from whom MRSA were isolated were treated with 2% mupirocin ointment under occlusive dressings, applied twice daily for 5 days. The average burned area treated was 8% (range, 2 to 20%) of the total body surface area. The burn wounds were assessed clinically and bacteriologically daily. Mupirocin eliminated MRSA in all 59 wounds treated, with the maximum therapeutic response seen within 4 days. In three wounds, gram-negative organisms persisted after 5 days of topical therapy. Treatment was well tolerated by all children. We recommend that mupirocin in its present polyethylene glycol base should be used only on a selective basis, when current prophylactic topical therapy has failed to control MRSA infection in burns of less than 20% of the total body surface area, and that it should be applied only for a limited period of 5 days. The safety and the efficacy of mupirocin in burns exceeding 20% of the total body surface area need to be established.

• Authors: H Rode, D Hanslo, P M de Wet, A J Millar, S Cywes
• Journal: Antimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 33 Issue 8 Pg. 1358-61 (Aug 1989) ISSN: 0066-4804 [Print] United States
• PMID: 2508545 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Fatty Acids
• Mupirocin
• Methicillin

Topics

• Anti-Bacterial Agents (therapeutic use)
• Burns (complications)
• Child
• Child, Preschool
• Fatty Acids (therapeutic use)
• Female
• Humans
• Infant
• Male
• Methicillin (pharmacology)
• Mupirocin
• Penicillin Resistance
• Staphylococcal Infections (drug therapy, etiology, microbiology)
• Staphylococcus aureus (drug effects)
• Time Factors
• Wound Infection (drug therapy, microbiology)